title: The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection.
abstract: For individuals with human immunodeficiency virus (HIV) infection to fully benefit from potent combination antiretroviral therapy, they need to know that they are HIV infected, be engaged in regular HIV care, and receive and adhere to effective antiretroviral therapy. Test-and-treat strategies for HIV prevention posit that expanded testing and earlier treatment of HIV infection could markedly decrease ongoing HIV transmission, stemming the HIV epidemic. However, poor engagement in care for HIV-infected individuals will substantially limit the effectiveness of test-and-treat strategies. We review the spectrum of engagement in care for HIV-infected individuals in the United States and apply this information to help understand the magnitude of the challenges that poor engagement in care will pose to test-and-treat strategies for HIV prevention.
authors.affiliation: Denver Public Health, Denver, Colorado, USA. edward.m.gardner@dhha.org
authors.forename: Edward M
authors.initials: EM
authors.lastname: Gardner
authors.forename: Margaret P
authors.initials: MP
authors.lastname: McLees
authors.forename: John F
authors.initials: JF
authors.lastname: Steiner
authors.forename: Carlos
authors.initials: C
authors.lastname: Del Rio
authors.forename: William J
authors.initials: WJ
authors.lastname: Burman
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D019380:Anti-HIV Agents